Individual provider Active NPI

Heather Diane Johnson, LMSW

  • Clinical Social Worker
  • Flint, MI
National Provider Identifier
1609358993
Registry record updated Jan 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801108430 Issued in MI
Practice address
1040 W Bristol Rd
Flint, MI 48507-5516
Phone
(734) 383-0465
NPI assigned
Sep 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801108430 MI Primary

Addresses

Primary practice location

1040 W Bristol Rd
Flint, MI 48507-5516

Mailing address

13184 River Rock Pass
Linden, MI 48451-8867
Phone (734) 383-0465

Other practice location 1

990 Villa St
Mountain View, CA 94041-1236
Phone (734) 383-0465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801108430MIMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1535932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737763200000",
    "number": "1609358993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13184 RIVER ROCK PASS",
            "city": "LINDEN",
            "state": "MI",
            "postal_code": "484518867",
            "telephone_number": "734-383-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 W BRISTOL RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485075516",
            "telephone_number": "734-383-0465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "990 Villa St",
            "address_purpose": "LOCATION",
            "city": "Mountain View",
            "state": "CA",
            "postal_code": "940411236",
            "country_code": "US",
            "telephone_number": "734-383-0465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HEATHER",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-03",
        "last_updated": "2025-01-25",
        "certification_date": "2025-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801108430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.